Insomnia and Waking in the Middle of the Night – Why It Happens

By Starlene on Tuesday, November 15th, 2011

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I've been experiencing bouts of insomnia for almost two decades. It first started happening when I was doing the low fat diet. Actually this is the only other diet I've done in my entire life until starting on GAPS.

I remember that I eventually learned if I would just get up and eat something with protein I would be able to go back to bed and get back to sleep. At the time, I was drinking soy milk because my children didn't like it and it was something quick and easy to have in the middle of the night. The thing is, when I wake in the middle of the night I don't feel hungry. In fact, the thought of eating seems perverse even sickening. But what happens is if I would just get up and stay up then I would find within a couple hours that I was actually very hungry. My stomach would start to growl ferociously. After that happened a few times, I realized I must be hungry so I should eat. Over the years, every so often I would experience insomnia. Since I work outside the home, it is uncomfortable and stressful to me when this happens. Here are some snippets from websites which explain why this can happen. I have read some of them before, but with my newfound information about cortisol and its importance to our very survival it has a whole new meaning on why this happens. I also recall reading somewhere that female hormones can play a part, but cannot find that reference at the moment.

When the adrenals fatigue, adrenal hormone levels may become low, leading to another possible source of nighttime sleep disruption – low blood sugar.* Cortisol plays an important role in maintaining blood sugar (glucose) levels around the clock. Although blood glucose is normally low by the early morning hours, during adrenal fatigue cortisol levels may not stay sufficient to adequately sustain blood glucose.* Low glucose signals an internal alarm (glucose is the main fuel for all cells, including brain cells) that disrupts sleep so the person can wake up and refuel.

Low nighttime blood glucose can also result from inadequate glycogen reserves in the liver. Cortisol causes these reserves to be broken down into glucose that is then available to the cells. When low cortisol and low glycogen reserves coincide, blood glucose will most likely drop, disrupting sleep.*

Waking between 1 AM and 3 AM may indicate low blood sugar resulting from inadequate glycogen reserves in the liver, low adrenal function and cortisol, or both. This is often the culprit when panic or anxiety attacks, nightmares, or fitful, restless sleep occur between 1:00 and 4:00 AM.

6. I fall asleep OK but then wake up during the night and find it difficult to get back to sleep. Those that rely on blood sugar as their primary source of fuel AND suffer some degree of glucose dysregulation and adrenal exhaustion may find themselves a member of the “3:00 AM Club”. As blood sugar levels drop during the night, normally it is cortisol that is gently released as a means of up-regulating it without disrupting sleep. Those prone to bigger blood sugar swings, or eat/drink a carbohydrate-rich substance near bedtime, and/or those who have exhausted adrenals and cannot produce adequate cortisol when needed may come to rely, instead, on adrenaline as their late-night blood sugar-stimulator. Adrenaline, you may recall, is our body’s primary “fight or flight” hormone and is designed to be used only in an emergency. Since low blood sugar is a form of “emergency” for those who are dependent upon sugar as their primary source of fuel, you may find yourself figuratively “outrunning a saber-toothed tiger” at 3:00 AM. (See pages 78, 84, 99, 119, 162 in Primal Body, Primal Mind: Beyond the Paleo Diet for Total Health and a Longer Life). Training your body to burn fat as its primary source of fuel and not sugar is key to ending this miserable nocturnal cycle, once and for all. Let Primal Body-Primal Mind show you how!

Typically in our society in which physical survival is not usually a daily source of stress, people handle their low-adrenal related hypoglycemia symptoms with a double-edged sword; they eat something sweet with a cup of coffee [affiliate link] or cola. This is a short acting emergency remedy that temporarily increases blood sugar with nearly immediate impact. They can almost feel it hit the back of their brain as their blood sugar moves out of the basement and shoots for the stars, relieving their hypoglycemic symptoms for about 45-90 minutes. However, this is inevitably followed by a precipitous plunge back to even lower blood sugar levels than they started with. Many individuals do this day in and day out, not realizing that hypoglycemia itself is a significant stress on the entire body, and especially on the adrenals.

To the body, hypoglycemia is a strong stressor, an emergency call to action that further drains already fatigued adrenals. People who treat their own hypoglycemia like the common example given above are on a constant roller-coaster ride throughout the day with their blood sugar erratically rising and then falling after each “sugar fix.” This throws not only cortisol and insulin levels into turmoil, but also the nervous system and the entire homeostasis of the body. Therefore, by the end of the day, the person may feel nearly exhausted without having done anything. It might take an entire evening or weekend to recover from this daily/weekly roller coaster ride. It has sometimes been characterized as driving with both the brakes and the accelerator pushed to the floor at the same time.

The early morning cortisol level should be the highest of the day giving us a strong start and enabling us to meet the demands of the day. A healthy person’s output of cortisol always follows the same curve, which can be plotted on a graph. It drops throughout the day until it falls to its lowest level by 11 p.m. or midnight, thus enabling us to be ready for bed and to sleep restfully throughout the night. Whenever the patient’s curve departs from the normal there is a problem. High night time cortisol means that the patient is finding it difficult to relax from the stress of the day and will have trouble going to sleep. This results in reduced REM sleep, a kind of sleep that is neither restful nor restorative, and which can produce depression and reduced energy levels the next day. (Italics mine – this is what I experience!)

Another kind of patient will have normal cortisol output in the afternoon and evening, but will have too high and too sudden a release of cortisol in the early morning. This will result in early morning wakening at around 5 or 6 a.m, or even 4 a.m. and an inability to go back to sleep. This, in my experience, is a major cause of insomnia in patients with ME.

So… these are reasons for insomnia that I've read about. I find the one reference to the “reduced REM sleep” to be quite fascinating as I have experienced that on and off for years. It's awful and other women I've spoken to also experience this weird kind of pretend sleep. Basically it feels like you are lying there for hours and hours, but it seems impossible to have truly lain there awake for such a long time, so you MUST have slept, but it doesn't feel like you slept a bit. The next day you feel exhausted and worn out.

I hope this helps you figure out what is going on with you if you have a sleep problem.

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5 comments to Insomnia and Waking in the Middle of the Night – Why It Happens

Hi Starlene, the info on the leptin reset and cortisol has been great. My hubby fits the bill so have started him on it as it goes well with GAPS, comments so far are that he is feeling full and is starting to sleep better, early days so will see how it goes, weight loss is his major goal and low carb isn’t enoungh so hoping the increased fat will do it! Have you looked at valarian for the panic attacks and night waking, I vaguely remember it lowers cortisol also but will have to track down the info again.

@Christie, thank you so much, I’m glad you are finding this helpful. It is such a great feeling to not have hunger throughout the day. I will look into valerian… thankfully the panic attacks seem to have stopped, and last night I had six hours sleep and actually felt halfway myself today at work. I am understanding the panic attacks (and adrenaline rushes) were related to low cortisol. Amazing what our bodies will do to try and keep going. Thanks again for your comment and I am very happy that you have found the information to be helpful. 🙂

I wonder… did you ever try EFT (Emotional Freedom Technique)for your panic attacks? Recently I heard miraculous stories about it from someone who’s sister is learning how to become an EFT instructor. It’s very easy to do. I’m starting it myself too.

@Saskia, I have not tried it, but I have looked into it. Another friend has recommended it so thank you for mentioning it. I know it’s important to get our thinking under control. I have not been having the middle of the night panic attacks in quite awhile. I believe mine were related to low cortisol levels. All of this is very interesting and really making me think differently on so many levels. Do you have any books you would recommend specifically on the EFT?